CPAPs: The Cure for Cardiovascular Disease?

According to Lawrence Epstein, MD, American Academy of Sleep Medicine (AASM) past president, medical director of Sleep Health Centers and instructor of medicine at Harvard Medical School, treating sleep disorders and getting an adequate amount of sleep are pillars of good cardiovascular health.

Feb. 1st kicked off American Heart Month, a month dedicated to awareness of the dangers of cardiovascular disease.

"Sleep apnea is a known risk factor for the development of hypertension, heart disease and stroke," said Epstein. "Also, chronic sleep deprivation has been shown to change metabolic function in a way that promotes weight gain and diabetes, two risk factors for heart disease."

Sleep Apnea & Cardiovascular Risk

A study published in the Dec. 1, 2006, issue of the journal SLEEP, showed that daytime sleepiness brought on by obstructive sleep apnea (OSA) may subtly impair cardiac function. People with OSA commonly complain of daytime sleepiness because of the fact that OSA causes the body to stop breathing during sleep the night before and can disturb sleep numerous times.

Further, data from the "Sleep Heart Health Study" show that people with sleep apnea have a 45 percent greater risk for hypertension, a major predictor for cardiovascular disease, than people without the sleep disorder.

Ralph Downey III, Ph.D., of the Sleep Disorders Center at Loma Linda University Medical Center in Loma Linda, Calif., says he is amazed at the high percentage of patients who have both sleep apnea and cardiovascular disease. Research has built a compelling case that those with sleep-disordered breathing are at increased risk for hypertension, said Downey, adding that there is also a well-established connection between sleep apnea and heart failure.

"It makes not only scientific sense that such a relationship exists, but common sense as well," said Downey. "If someone were to suffocate you with a pillow several hundred times a night, you would call the police. In the case of patients with sleep apnea, the airway blocks off due to obstruction and they stop breathing for 10 seconds to a minute, which is repeated hundreds of times in a night. The body, in essence, is being assaulted by the damage done from intermittent lack of oxygen to the heart, brain and other important organ systems, and yet such an assault goes unreported. That is, patients who have these symptoms don't always have their sleep apnea corrected. Perhaps in the light of a metaphor such as the one of being assaulted by our own sleep disorder, people would take more care of their sleep. Their hearts will thank them."

A CPAP Prescription

Fortunately, people with sleep apnea who use CPAPs can experience improvements to their cardiovascular health.

"CPAP as long as you use it essentially cures sleep apnea," says Dr. William Abraham, professor of Internal Medicine, director of the division of Cardiovascular Medicine and deputy director at Davis Heart & Lung Research Institute, The Ohio State University. "With all of the new CPAP devices and all of the new masks and ways of delivering CPAP, the adherence rate (and) the patient compliance rate is very high in centers which are really motivated to work with patients on CPAP."

In fact, CPAP treatment "maintains the oxygen level at a normal range; it lowers sympathetic activation; it reduces the wall stress on the heart; it lowers blood pressure," says Abraham. "It has been show in heart failure patients to actually result in strengthening of the heart. The weak, failing heart actually gets stronger over time with the use of CPAP. So, it really is remarkable how beneficial it can be in these patients."

Check out Sleep Therapy for more on the latest CPAPs.

This article originally appeared in the January 2007 issue of HME Business.


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